Pharmacy Benefits Investigation - BioPlus Specialty Pharmacy

Elevance Health • St. Louis, MO

3d • Hybrid

About The Position

Pharmacy Customer Associate II LOCATION: This is a virtual eligible role. You must be within a reasonable commuting distance of one of our offices. HOURS: 11:30 am - 8:30 pm, ET, Monday through Friday. TRAINING: 5 Weeks, training will be conducted during regular business hours, 8:00 am - 5:00 pm or 9:00 am - 6:00 pm, ET. Virtual: This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. This approach promotes productivity, supports work-life integration, and ensures essential face-to-face onboarding and skill development. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. Pharmacy Techs! The Pharmacy Customer Associate II is responsible for responding to basic customer questions via telephone and written correspondence regarding pharmacy retail and mail order prescriptions. Primary responsibilities include, but are not limited to: Develops and maintains positive customer relations and coordinates with functions within the company to ensure customer requests are handled and resolved appropriately and in a timely manner. Interacts with internal and external customers (could include subscribers, providers, group or benefit administrators, physician offices, third party representatives, and other Blue Cross Plans) to provide claims, customer service, and/or membership support. Completes necessary research to provide proactive, thorough solutions. Displays ownership of service requests ensuring high quality resolution and follow-thru. Supports and guides the customer with their personal options and decisions and helps the customer become knowledgeable and confident about using technology, tools and resources available to them.

Requirements

• Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.

Nice To Haves

• 2+ years of Specialty Pharmacy experience strongly preferred.
• Certified or Registered Pharmacy Technician preferred.
• Experience with pharmacy benefits investigation strongly preferred.
• Experience processing/interpreting pharmacy claims is very helpful.
• Experience with pharmacy prior authorizations and pharmacy billing is very helpful.
• Experience working with a variety of therapy types is very helpful.
• Strong critical thinking skills are a must for this position.

Responsibilities

• Develops and maintains positive customer relations and coordinates with functions within the company to ensure customer requests are handled and resolved appropriately and in a timely manner.
• Interacts with internal and external customers (could include subscribers, providers, group or benefit administrators, physician offices, third party representatives, and other Blue Cross Plans) to provide claims, customer service, and/or membership support.
• Completes necessary research to provide proactive, thorough solutions.
• Displays ownership of service requests ensuring high quality resolution and follow-thru.
• Supports and guides the customer with their personal options and decisions and helps the customer become knowledgeable and confident about using technology, tools and resources available to them.

Benefits

• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED